The most common reasons for shoulder replacement surgery are chronic pain and restricted movement.
Your shoulder is the most mobile joint in your entire body, which allows you the freedom to perform everyday tasks, like getting dressed and brushing your hair. However, with chronic shoulder pain, these tasks can be extremely limited.
Arthritis can develop from tearing or dislocating your rotator cuff, fracturing your shoulder, an autoimmune disease, or simply wear and tear over a period of time. There are several different types of arthritis. Osteoarthritis, post-traumatic arthritis, and rheumatoid arthritis are the ones that most commonly affect the shoulder. Arthritis causes your cartilage to break down, which causes the ball and socket of your shoulder joint to rub against each other. This can be quite painful and leads to some swelling and a limited range of motion. Shoulder replacement surgery should be recommended when lack of mobility and pain reach an advanced point.
Rotator cuff tears are common, especially after the age of 40. The tendons that make up the rotator cuff continually weaken as we grow older, making them much more likely to tear when we fall or perform repetitive overhead activities, like swimming and weightlifting. When a torn rotator cuff is not repaired, the shoulder cannot move the way it is supposed to which causes wear and tear on the joint. As time passes, arthritis develops and the function of the rotator cuff may be lost entirely, resulting in cuff tear arthropathy.
With larger rotator cuff tears that cannot be repaired and rotator cuff arthropathy, reverse shoulder replacement is commonly recommended.
A shoulder fracture can be caused by a car crash, a fall, or contact sports. It involves one of the three shoulder bones: scapula, humerus, or clavicle. The most common fracture is a break in the “ball” of the shoulder joint, or proximal humerus fracture. These breaks are very common in older people with low-impact falls due to their poor bone density (osteoporosis). Shoulder fractures are often treated without surgery, however with this break where the bones are displaced from their normal position, surgery might be recommended. This may involve the realignment of the bones and holding them in place with nails, plates, and screws. When this cannot be performed, shoulder replacement surgery may be recommended.
Shoulder dislocations commonly occur when you try to “catch” your fall with an outstretched arm. This can force the humerus to shift out of the socket and move towards the front of the body. After dislocating the shoulder once, you are at a higher risk of having more dislocations. The rotator cuff may also tear when the dislocation occurs. If the rotator cuff cannot be repaired or is torn completely, shoulder replacements might be recommended.
Your shoulder is a ball and socket joint. The ball (humeral head) is at the top of the humerus, the long bone that runs from your shoulder down to your elbow. This fits into the socket (glenoid), which is formed by your scapula and clavicle. A soft tissue called articular cartilage covers the ball and socket. This allows the movement of your shoulder to be pain-free.
Your rotator cuff is made up of four muscles that form a tendon cuff over the humeral head, or “ball” of your shoulder. This allows you to lift and rotate your arm and move your shoulder in different directions. It also helps the ball stay in the center of the socket.